FOREIGN BODY INGESTION

Accidental foreign body (FB) ingestion such as - coins, fish bones, toys plastic parts, jewels, batteries,
safety pin, needles, etc. - is a common problem in children, specially infants and toddlers. Infants usually swallow button batteries while coins are the most frequently swallowed objects in children over the age of three years. No child ingests more than one foreign body. Management of esophageal foreign body differs from the rest of the gastrointestinal tract. Diagnosis is made by either chest-x-ray, barium swallow or esophagoscopy. They should be suspected when the child develops excessive salivation, vomiting, respiratory distress, recent-onset asthma, dysphagia and hematemesis. FB in the esophagus should be removed urgently to avoid erosion and perforation, specially those lodge in the upper-third of the esophagus. They can be removed using flexible fiberoptic endoscopy, balloon catheter or bougienage. Beyond the stomach, foreign body should be managed conservatively. This means follow-up visits until the foreign body spontaneously appears in the feces. In cases of coins ingestion serious complications are extremely rare. There is no need to x-ray monitor coins or any other metallic
FB. More than 85% of all ingested FB passes spontaneously through the rectum despite nature or length. Surgery will be needed in less than 2% of all ingested FB. Patients with previous abdominal surgery are at increased risk. Development of abdominal pain, distension or profuse bleeding is an indication to remove the foreign body surgically.